Helping the 'neediest of needy'New program will bring dental care to refugees in Tanzania
Posted April 6, 2007
By Stacie Crozier

Kigoma, Tanzania—All that was supposed to happen was a tooth
getting pulled.
Instead, in early 2005, a refugee living in a long-term camp in Western
Tanzania died.

His death at a nearby hospital from a severe infection of the face
and neck that developed after a fellow refugee pulled his tooth inspired
a local priest to take action.

Fr. Paul Flamm, a Catholic missionary with the Congregation of the
Holy Spirit, or the Spiritans, was disturbed by the dire need for
dental care in Tanzania's refugee camps. He contacted the ADA Center
for International Development and Affairs for help.

Working toward smiles: Children in a Tanzanian
refugee camp pause for a photo after receiving oral health education,
oral care supplies, school supplies and soccer balls from ADA, HVO
and CDC site visitors in March 2006.

In less than two years, the ADA—with help and support from the
Colgate-Palmolive Co., the Centers for Disease Control and Prevention,
Health Volunteers Overseas, the International College of Dentists,
the faculty of dentistry at Muhimbili University, the Tanzania Dental
Association and the nongovernmental organization Dentaid—is
coordinating the delivery of dental equipment to Tanzania so two refugee
camps will be able to provide dental care on-site.

And, by this summer, HVO will be able to establish a volunteer program
for U.S. dentists to provide care, and later develop a training program
that will help meet refugees' dental health needs in the future.

"Fr. Flamm's request for help necessitated a site visit
to determine how we could best help the refugees," says Helen
Cherrett, CIDA director. "The ADA has been patiently working
behind the scenes and now the project is starting to come together."

Ms. Cherrett credits the Colgate-Palmolive Co. and Dr. Anthony Volpe,
vice president, Scientific Affairs, for providing a grant of $20,000
to cover the cost of conducting the first-ever site visit and dental
health assessment of a long-term refugee camp by a team of ADA, HVO
and CDC personnel.

"We are so grateful for the visionary
leap they made to get the project started," she says. "From
there, we were able to make recommendations and propose a four-phase
program for HVO to establish a volunteer/training program."

"The Colgate-Palmolive Co. was very honored to be a partner
with the American Dental Association with regard to its humanitarian
children's oral health educational initiative in Tanzania," said
Dr. Volpe. "The ADA and Colgate share the joint vision of reducing
dental disease in children across the world by teaching them proper
oral hygiene practices."

"I think this was a pioneer work in many aspects,"
says Dr. Beltrán. "It is the first oral health assessment
of population groups living for more than 10 years in refugee camps.
Also, there are a lot of ADA members who have expressed their desire
to volunteer overseas. This is one place where small contributions
will make tremendous effects because there is so much unmet need.
Refugee communities live in very humble environments; they receive
food, shelter and health care, but attending to their oral health
problems is not considered a priority. They can't work and earn a
living to pay for other goods and services, something we take for
granted in other parts of the world. Thus, it is not surprising that
after 10 years living in these conditions that oral health becomes
an issue."

"We identified the prevalence and severity
of dental caries and periodontal diseases in refugees and recommended
appropriate preventive and control measures to be implemented by the
ADA and HVO in a future project," says Dr. Jaramillo. The next
step, he says, is for the ADA and HVO to implement training and volunteer
opportunities in the camps.

The site visitors also spent time teaching oral hygiene to students
in the refugee camps, distributed thousands of toothbrushes and tubes
of toothpaste and "also gave well-appreciated gifts of notebooks,
pens and soccer balls to the some 5,000 secondary students in the
Mtabila and Muyovozi camps," says Fr. Flamm. The school supplies
and balls were purchased with donations by ADA employees.

Upgrade: Refugees will soon be able to receive
dental care on-site in a real dental chair instead of the wooden one
above.

"On behalf of the refugee community
and their Tanzanian hosts, we would like to express our deep gratitude
to the members of the site assessment team for the generous gift of
their time and energies, as well as to all at the ADA, the CDC, the
HVO, the Colgate Palmolive Co., and Dr. Anthony Volpe in showing their
concern for their well-being by making this intervention possible,"
adds Fr. Flamm. "We look forward with great hope to the planned
future interventions which will no doubt make a significant contribution
to the improvement of dental care for the people in the camps and
in the surrounding villages."

Fr. Flamm says that the latest statistics from the United Nations
High Commissioner for Refugees agency show a current population of
about 65,000 in the Mtabila and Muyovozi camps. "The vast majority
of them have lived here in exile for over 10 years."
Although thousands of refugees are expected to be repatriated by the
end of 2007, there will still be about 40,000 refugees remaining at
the end of this year.

The refugees, he adds, receive "a meager bi-weekly distribution
of food aid, free health care and free primary school education. All
housing is temporary, constructed of either sun-dried mud bricks or
mud packed walls and plastic sheeting for roofing."
The Tanzanian Red Cross Society provides health care services for
the camps under the auspices of the UNHRC, says Dr. Robison, a past
member of the Health Volunteers Overseas steering committee. "UNHRC
doesn't address dental care for refugees, but since these individuals
have lived as refugees for 10 years or more, they have desperate dental
needs. They are the neediest of the needy. They may be getting their
basic health needs met, but with dental care, there's a real gap."

Dr. Robison, who lived in Tanzania and worked in oral health care
development from 1983-1990, says last year's trip, the findings of
the team and the plans for future projects are close to her heart.

The team recommended providing Kabanga Hospital with two completely
refurbished dental chair set ups and placing the old dental chairs
in the Mtabila II and Nyaragusu refugee camps.

The survey may also be a helpful tool for lobbying to add dental care
to the UNHRC's services, says Dr. Robison.
Thanks to a $15,000 grant from the International College of Dentists,
the ADA contracted with Dentaid, a charitable organization in the
United Kingdom dedicated to improving oral health worldwide, to prepare
and ship the equipment. It is now en route to Kabanga. "The
ICD has a history of participating in the promotion of dental health
on a worldwide basis," says Dr. James Felix. "We will continue
to seek opportunities to be of service for the dental health of the
world."

The team is thrilled that three phases of its four-phase plan have
now been completed.

"It's very exciting. When the dental
equipment is set up in the refugee camps, we will be able to send
volunteer dentists who can provide care," says Ms. Cherrett.
"Then we can proceed to Phase 4, when ADA/HVO volunteers and
Tanzanian dental personnel can provide more in-depth training through
seminars and implement oral health promotion curriculum in the community
and schools."

"The work in the refugee camps linking
the dental school and the local oral health service will provide much
needed help in the area," says Dr. Hobdell, who has volunteered
as a clinician and educator in Tanzania since 1976. "The CE courses
and teaching in the dental school will be a great support to faculty
and students alike. And the Tanzanian Dental Association's enthusiasm
for the project bodes well for its success."